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Lipid profiles in middle-aged men and women after famine exposure during gestation: the Dutch Hunger Winter Families Study^1,2,3,4

¹ From the Mailman School of Public Health, Columbia University, New York, NY (LHL); the Hubert Department of Global Health, Emory University, Atlanta GA (ADS); the Centers for Disease Control and Prevention, Atlanta, GA (HSK); and the Leiden University Medical Center, Leiden, Netherlands (JAR).

² The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

³ Supported by the National Heart, Lung, and Blood Institute, NIH (R01 HL-067914; principal investigator: LHL).

⁴ Address correspondence to LH Lumey, Columbia University, Department of Epidemiology, Mailman School of Public Health, 722 West 168th Street, New York NY 10032. E-mail: lumey{at}columbia.edu.

Background: Many studies in humans have related birth weight to lipid profiles in adulthood. Fewer have estimated associations directly attributable to maternal nutrition during pregnancy.

Objective: Our objective was to determine whether famine exposure during gestation is associated with a more atherogenic profile in adult offspring.

Design: In 2003–2005, we studied 1) 359 singleton men and women born between January 1945 and March 1946 in clinics in Amsterdam, Rotterdam, and Leiden whose mothers were exposed to the famine during pregnancy; 2) 299 singletons born in the same 3 institutions during 1943 or 1947; and 3) 313 unexposed same-sex siblings of the above individuals. A lipid profile was obtained after an overnight fast.

Results: Female offspring with prenatal famine exposure had a dyslipidemic pattern characterized by elevated total cholesterol (0.26 mmol/L; 95% CI: 0.07, 0.46; P = 0.007), triglycerides (0.17 mmol/L; 95% CI: 0.03, 0.31; P = 0.02), and LDL cholesterol (0.17 mmol/L; 95% CI: –0.01, 0.36; P = 0.06) compared with unexposed offspring. This pattern was not seen in men. The increases in total cholesterol and LDL cholesterol were independent of body mass index, waist circumference, and midthigh circumference. The increase in triglycerides was independent of midthigh circumference but was attenuated with control for either body mass index or waist circumference. There was no evidence for associations within specific gestational windows. No association was observed between prenatal famine exposure and HDL cholesterol in either sex.

Conclusion: In women, but not in men, aged 58 y, we observed an association between prenatal undernutrition and elevated total cholesterol concentrations and triglycerides.

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